Provider Demographics
NPI:1801163688
Name:BRATTAIN, PATRICIA MAREN (DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MAREN
Last Name:BRATTAIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 RIVER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-5412
Mailing Address - Country:US
Mailing Address - Phone:541-683-6187
Mailing Address - Fax:
Practice Address - Street 1:2401 RIVER RD STE 102
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-5412
Practice Address - Country:US
Practice Address - Phone:541-683-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist